Treatment of annular tears consists of a series of epidural steroid injections (caudal, lumbar or cervical), or a nerve root block. Topically applied depot steroids (triamcinolone) help to reduce nerve root inflammation, and produce pain relief usually lasting 6 - 8 weeks per injection. Epidurals can produce significant pain relief allowing earlier rehabilitation and recovery. Chronic annular tears may be helped by Intra-discal Electro Thermal Annuloplasty (IDET).
Tarlov cysts are fluid-filled sacs that most often affect nerve roots in the sacrum, the group of bones at the base of the spine. These cysts can compress nerve roots, causing lower back pain, sciatica (shock-like or burning pain in the lower back, buttocks, and down one leg to below the knee), urinary incontinence, sexual dysfunction, and some loss of feeling or control of movement in the leg and/or foot. Pressure on the nerves next to the cysts can also cause pain. Tarlov cysts may become symptomatic following shock, trauma, or exertion that causes the buildup of cerebrospinal fluid. Women are at much higher risk of developing these cysts than are men.
Tarlov cysts may be drained to relieve pressure and pain, but relief is often only temporary and fluid build-up in the cysts will recur. Corticosteroid injections may also temporarily relieve pain. Other drugs may be prescribed to treat chronic pain and depression. Filling the cysts with fat has not been shown to work. Injecting the cysts with fibrin glue (a combination of naturally occurring substances based on the clotting factor in blood) may provide temporary relief of pain. Some scientists believe the herpes simplex virus, which thrives in an alkaline environment, can cause Tarlov cysts to become symptomatic; making the body less alkaline, through diet or supplements, may lesson symptoms. Microsurgical removal of the cyst may be be an opton in select individuals who do not respond to conservative treatments and who continue to experience pain or progressive neurological damage. Most Tarlov cysts do not cause pain, weakness, or nerve root compression. Acute and chronic pain may require changes in lifestyle. If left untreated, nerve root compression can cause permanent neurological damage
Despite advancements in diagnosis, there remains a great deal of controversy regarding the optimal treatment of symptomatic Tarlov cysts. Nonsurgical therapies include lumbar CSF drainage and CT scanning guided cyst aspiration, neither of which prevents symptomatic cyst recurrence. Neurosurgical techniques for symptomatic perineurial cysts include simple decompressive laminectomy, cyst and/or nerve root excision,] and microsurgical cyst fenestration and imbrication. Although no consensus exists on the definitive treatment of symptomatic Tarlov cysts it is believed that surgical methods have yielded the best long-term results to date.
Bed rest may help in healing also consult a physiotherapist for pain management.
i herniated my L2-3 2 yrs ago, was exremley painful. i have still suffereb pain sometimes a 10 on the pain scale. i just had a nri, showed several buldging disc, digeneritive disc disease, mild to moderate changed. and annular tears in the L3-4 ans 4-5, now when i had the lamonectomy it shot out like a zit the surgen said, said ther was a extreme amount of pressure. now i have a very low , and i mean almost nuthin reflex in my rt leg, pain in the siatica, and femoral nerves on a constant basis. my lower back feels like its gonna slip sometimes whem i bend, my question, is that i beleve i got these tears during surgery, or when the disc herniatede . my question is, will the tear hill if its been almost 3 yrs? i havent had anything happen to me to have caused these tears.thanks, stephanie